Remnant Lipoprotein Cholesterol and Incident Coronary Heart Disease: The Jackson Heart and Framingham Offspring Cohort Studies
BackgroundRemnant lipoproteins (RLPs), the triglyceride‐enriched precursors to low‐density lipoprotein, are an emerging risk factor for coronary heart disease (CHD). We sought to determine the association of RLP cholesterol (RLP‐C) levels with incident CHD in 2 diverse, prospective, longitudinal obs...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2016-05-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.115.002765 |
| _version_ | 1811275148299337728 |
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| author | Parag H. Joshi Arif A. Khokhar Joseph M. Massaro Seth T. Lirette Michael E. Griswold Seth S. Martin Michael J. Blaha Krishnaji R. Kulkarni Adolfo Correa Ralph B. D'Agostino Steven R. Jones Peter P. Toth |
| author_facet | Parag H. Joshi Arif A. Khokhar Joseph M. Massaro Seth T. Lirette Michael E. Griswold Seth S. Martin Michael J. Blaha Krishnaji R. Kulkarni Adolfo Correa Ralph B. D'Agostino Steven R. Jones Peter P. Toth |
| author_sort | Parag H. Joshi |
| collection | DOAJ |
| description | BackgroundRemnant lipoproteins (RLPs), the triglyceride‐enriched precursors to low‐density lipoprotein, are an emerging risk factor for coronary heart disease (CHD). We sought to determine the association of RLP cholesterol (RLP‐C) levels with incident CHD in 2 diverse, prospective, longitudinal observational US cohorts. Methods and ResultsWe analyzed cholesterol levels from serum lipoprotein samples separated via density gradient ultracentrifugation in 4114 US black participants (mean age 53.8 years, 64% women) from the Jackson Heart Study and a random sample of 818 predominantly white participants (mean age 57.3 years, 52% women) from the Framingham Offspring Cohort Study. Multivariable‐adjusted hazard ratios (HRs) for RLP‐C (the sum of very low‐density lipoprotein3 cholesterol and intermediate‐density lipoprotein cholesterol) were derived to estimate associations with incident CHD events consisting of myocardial infarction, CHD death, and revascularizations for each cohort separately and as a combined population. There were 146 CHD events in the combined population. After adjustments for age, sex, body mass index, smoking, blood pressure, diabetes, and lipid‐lowering therapy for the combined population, RLP‐C (HR 1.23 per 1‐SD increase, 95% CI 1.06–1.42, P<0.01) and intermediate‐density lipoprotein cholesterol (HR 1.26 per 1‐SD increase, 95% CI 1.08–1.47, P<0.01) predicted CHD during an 8‐year follow‐up. Associations were attenuated by high‐density lipoprotein cholesterol and ultimately lost significance with inclusion of real low‐density lipoprotein cholesterol, which excludes Lp(a) and IDL cholesterol fractions. Similar associations were seen in multivariable analyses within each cohort. ConclusionRLP‐C levels are predictive of incident CHD in this diverse group of primary prevention subjects. Interventions aimed at reducing RLP‐C to prevent CHD warrant further intensive investigation. Clinical Trial RegistrationURL: http://www.ClinicalTrials.gov. Unique identifier: NCT00415415. |
| first_indexed | 2024-04-12T23:32:53Z |
| format | Article |
| id | doaj.art-8f215e1d07c849c9b00c05456b1ecbf5 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-12T23:32:53Z |
| publishDate | 2016-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-8f215e1d07c849c9b00c05456b1ecbf52022-12-22T03:12:14ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802016-05-015510.1161/JAHA.115.002765Remnant Lipoprotein Cholesterol and Incident Coronary Heart Disease: The Jackson Heart and Framingham Offspring Cohort StudiesParag H. Joshi0Arif A. Khokhar1Joseph M. Massaro2Seth T. Lirette3Michael E. Griswold4Seth S. Martin5Michael J. Blaha6Krishnaji R. Kulkarni7Adolfo Correa8Ralph B. D'Agostino9Steven R. Jones10Peter P. Toth11Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MDRoyal Brompton and Harefield NHS Trust, London, UKDepartment of Biostatistics, Boston University School of Public Health, Boston, MACenter of Biostatistics & Bioinformatics, University of Mississippi Medical Center, Jackson, MSCenter of Biostatistics & Bioinformatics, University of Mississippi Medical Center, Jackson, MSJohns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MDJohns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MDAtherotech Diagnostics Laboratory, Birmingham, ALJackson Heart Study, University of Mississippi Medical Center, Jackson, MSDepartment of Biostatistics, Boston University School of Public Health, Boston, MAJohns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MDJohns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MDBackgroundRemnant lipoproteins (RLPs), the triglyceride‐enriched precursors to low‐density lipoprotein, are an emerging risk factor for coronary heart disease (CHD). We sought to determine the association of RLP cholesterol (RLP‐C) levels with incident CHD in 2 diverse, prospective, longitudinal observational US cohorts. Methods and ResultsWe analyzed cholesterol levels from serum lipoprotein samples separated via density gradient ultracentrifugation in 4114 US black participants (mean age 53.8 years, 64% women) from the Jackson Heart Study and a random sample of 818 predominantly white participants (mean age 57.3 years, 52% women) from the Framingham Offspring Cohort Study. Multivariable‐adjusted hazard ratios (HRs) for RLP‐C (the sum of very low‐density lipoprotein3 cholesterol and intermediate‐density lipoprotein cholesterol) were derived to estimate associations with incident CHD events consisting of myocardial infarction, CHD death, and revascularizations for each cohort separately and as a combined population. There were 146 CHD events in the combined population. After adjustments for age, sex, body mass index, smoking, blood pressure, diabetes, and lipid‐lowering therapy for the combined population, RLP‐C (HR 1.23 per 1‐SD increase, 95% CI 1.06–1.42, P<0.01) and intermediate‐density lipoprotein cholesterol (HR 1.26 per 1‐SD increase, 95% CI 1.08–1.47, P<0.01) predicted CHD during an 8‐year follow‐up. Associations were attenuated by high‐density lipoprotein cholesterol and ultimately lost significance with inclusion of real low‐density lipoprotein cholesterol, which excludes Lp(a) and IDL cholesterol fractions. Similar associations were seen in multivariable analyses within each cohort. ConclusionRLP‐C levels are predictive of incident CHD in this diverse group of primary prevention subjects. Interventions aimed at reducing RLP‐C to prevent CHD warrant further intensive investigation. Clinical Trial RegistrationURL: http://www.ClinicalTrials.gov. Unique identifier: NCT00415415.https://www.ahajournals.org/doi/10.1161/JAHA.115.002765coronary heart diseaselipidsprimary preventionremnant lipoprotein cholesteroltriglycerides |
| spellingShingle | Parag H. Joshi Arif A. Khokhar Joseph M. Massaro Seth T. Lirette Michael E. Griswold Seth S. Martin Michael J. Blaha Krishnaji R. Kulkarni Adolfo Correa Ralph B. D'Agostino Steven R. Jones Peter P. Toth Remnant Lipoprotein Cholesterol and Incident Coronary Heart Disease: The Jackson Heart and Framingham Offspring Cohort Studies Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease coronary heart disease lipids primary prevention remnant lipoprotein cholesterol triglycerides |
| title | Remnant Lipoprotein Cholesterol and Incident Coronary Heart Disease: The Jackson Heart and Framingham Offspring Cohort Studies |
| title_full | Remnant Lipoprotein Cholesterol and Incident Coronary Heart Disease: The Jackson Heart and Framingham Offspring Cohort Studies |
| title_fullStr | Remnant Lipoprotein Cholesterol and Incident Coronary Heart Disease: The Jackson Heart and Framingham Offspring Cohort Studies |
| title_full_unstemmed | Remnant Lipoprotein Cholesterol and Incident Coronary Heart Disease: The Jackson Heart and Framingham Offspring Cohort Studies |
| title_short | Remnant Lipoprotein Cholesterol and Incident Coronary Heart Disease: The Jackson Heart and Framingham Offspring Cohort Studies |
| title_sort | remnant lipoprotein cholesterol and incident coronary heart disease the jackson heart and framingham offspring cohort studies |
| topic | coronary heart disease lipids primary prevention remnant lipoprotein cholesterol triglycerides |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.115.002765 |
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